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Phimosis and Paraphimosis

What is phimosis and paraphimosis?

Phimosis is a constriction of the opening of the foreskin so that it can't be drawn back over the tip of the penis. This condition is a normal occurrence in the newborn boy, but over time the skin that adheres to the tip of the penis can be retracted as the foreskin loosens. By age 17, around 99% of males will be able to completely retract their foreskin. Phimosis can also occur if the foreskin is forced back before it is ready. This can cause a fibrous scar to form, which may prevent future retraction of the foreskin.

Paraphimosis occurs when the foreskin is retracted behind the corona (or crown) of the penis and can't be returned to the unretracted position. This can cause entrapment of the penis, impairing the drainage of blood, and may be serious.

What are the symptoms of phimosis and paraphimosis?

The following are the most common symptoms of phimosis and paraphimosis.

Phimosis:

Bulging of the foreskin during urination

Inability to completely retract the foreskin by age 3 (in some children this process may take longer)

Paraphimosis:

Swelling of the tip of the penis as the foreskin is retracted or pulled back

Pain

Inability to pull the foreskin back over the tip of the penis

Discoloration, either dark red or bluish color, of the tip of the penis

The symptoms of phimosis and paraphimosis may look like other problems or medical conditions. Always consult your child's doctor for a diagnosis.

How is phimosis or paraphimosis diagnosed?

A careful physical exam by your child's doctor normally provides enough information to make a diagnosis.

What is the treatment for phimosis and paraphimosis?

Your baby’s health care provider will figure out the best treatment based on:

How old your baby is

His or her overall health and medical history

How sick he or she is

How well your baby can handle specific medications, procedures, or therapies

How long the condition is expected to last

Your opinion or preference

Treatment may include the following:

For repeated phimosis, application of a steroid cream to the foreskin up to 3 times a day for about a month will loosen the adhesive ring. If the child has ballooning of the foreskin during urination after age 10, a circumcision (surgical removal of all or part of the foreskin) may be recommended.

For paraphimosis, it may involve lubricating the foreskin and tip of the penis and then gently squeezing the tip of the penis while pulling the foreskin forward. If this is ineffective, a small incision to relieve the tension may be performed. An emergency circumcision (surgical removal of all or part of the foreskin) may be recommended.

Please consult your doctor with any questions or concerns you may have regarding your child's condition.